Provider Demographics
NPI:1467508093
Name:FRYKMAN, CHRISTOPHER ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:FRYKMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20801 AZTEC ST NW
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-8847
Mailing Address - Country:US
Mailing Address - Phone:612-516-3772
Mailing Address - Fax:
Practice Address - Street 1:18258 MINNETONKA BLVD, WAYZATA MN 55392
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-2601
Practice Address - Country:US
Practice Address - Phone:612-516-3772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN490031600OtherMEDICAL ASSISTANCE
MN2427076OtherRN
MN350003301Medicare ID - Type Unspecified